Provider Demographics
NPI:1215953088
Name:FLEMING, RITA (MD)
Entity type:Individual
Prefix:DR
First Name:RITA
Middle Name:
Last Name:FLEMING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 S JACKSON ST FL ST2
Mailing Address - Street 2:DEPT OB/GYN ATT: VICKI MASTERSON
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1622
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:401 E CHESTNUT ST
Practice Address - Street 2:SUITE 410
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-5700
Practice Address - Country:US
Practice Address - Phone:502-271-5999
Practice Address - Fax:502-271-5994
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY24679207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100322820Medicaid
KY50003185OtherPASSPORT SPECIALITY # - PSC
KY50003186OtherPASSPORT SPECIALITY - FOUNDATION
KY000000359399OtherANTHEM - PSC
KY50003184OtherPASSPORT PCP# - FOUNDATION
KY64246796Medicaid
KY0000003574880OtherANTHEM - FOUNDATION
KY00533087OtherMEDICARE KY FOR NORTON'S HOSPITAL EFF DATE 11-16-08
IN100322820Medicaid
KY0722518Medicare PIN
KY50003186OtherPASSPORT SPECIALITY - FOUNDATION